12-103161If ,
Building - Single Family
City of Federal Way
Community & Econ. Dev. Services Permit #: 12-103161-00-S F
33325 8th Ave S r
Federal way, WA 98003 r Inspection Request Line: 253 835-3050
Ph: (253) 835-2607 Fax: (253) 835-2609 �: p Q
Project Name: KUZYK
Project Address: 30146 3RD PL S
Parcel Number: 795450 0060
Project Description: REP - Remove existing shake roofing and replace with composition shingles
Owner
Anolicant
Contractor
Lender
BRETT M KUZYK
BRETT M KUZYK
OWNER IS CONTRACTOR
OWNER IS LENDER
RAE ANN KUZYK
30146 3RD PL S
30146 3RD PL S
FEDERAL WAY WA
FEDERAL WAY WA
980034077
98003
ARRlicant
RAE ANN KUZYK
30146 3RD PL S
FEDERAL WAY WA
98003
3
•
Census Category: 555 ctur roorm its
Includes: #1#2 3 #4
Occupancy Class:
Construction T e:
Occu anc LoadV lvl� A4
Floor Areas . ft. 0 0 0
N—
Ad ionat Pe it 'brrnation
New / Additional Sq. FVt - 3rd Fl .......... New / Additional Sq. Feet - Basement...................0
Mechanical to be Include .. ........ ........ . o Plumbing to be Included? ....................................... No
No F' res AssoclatetWith This Permit 11
�► er
PERMIeREES Sunday, January 6, 2013
Pe sued on Tuesday, July 10, 2012
1 hereby certify that th bove inform n is correct and that the construction on the above described property and
the occupancy and a use will be in accordance with the laws, rules and regulations of the State of Washington
29�
City of Federal Way.
Owner or agent: Date: / /�
CITY OF Ail:&
Federal Way
PERMIT #:
Project:
THIS CARD IS TO REMAIN ON-SITE
Construction Inspection Record
INSPECTION REQUESTS: (253) 835-3050
12 -103161 -00 -SF Address: 30146 3RD PL S
BRETT M KUZYK FEDERAL WAY, WA 98003-4077
Scheduled inspections may be failed if this card is not on-site. DO NOT LOSE THIS CARD. Inspections are listed as close to sequential order as
possible (read left to right, top to bottom). Please schedule inspections as appropriate. Work must not be covered until it is approved. Check with your
inspector if you are unsure about any of the inspections or the inspection sequence. On-going inspections are logged on the back of this card.
0
SWM Precon Site Mtg (4400)
Initial Erosion Control (4365)
Walls (4245)
Underfloor Framing (4285)
E] Roof Sheathing (4220)
Approved
Approved to install flooring
To be done prior to breaking ground
Approved to sheath floor
By
Date
By
Date
By
Date
0
Floor Sheathing (4105)Shear
1:1Approved
Walls (4245)
E] Roof Sheathing (4220)
Right of Way
Approved to install flooring
Date
Approved to install siding
Approved to install roofing
By
Date
Date
By
Date
By GF Date
0
Fire/Draft Stops (4095)
Interim Erosion Control (4370)EFZ&Diraft
Approved
Approved
eduling a Framing inspection;
bing & Mechanical Rough -in and
Date
By
Datepproved
inspections must be signed-offandBy
IBC 109.3.4
Gypsum Wallboard Nailing (4130)
Framing (4120)
Insulation (4150)
Approved to insulate
Approved to install wallboard
Approved to install mud & tape
By
Date
By
Date
By Date
E]
Final Erosion Control (4375)
Final - Building (4050)
Approved
Approved
By
Date
By
Date
Rough Electrical
Approved
1:1Approved
Final Electrical
1:1Approved
Right of Way
By
Date
By
Date
By
Date
Federal vV ECEIVEp WERMIT
COMMUMT y DEVELOPMENT Sy O^ 0 AAPPLICATION
253-835-2,,,-,-,,,,,,,,,W 1 L L
EMIT...rrtro erirratu.mr. coxe
CITY OF FEDERAL WAY
FCO ME PL DE EN FP
5.q 4 ��
SITE ADDRESS�� �
¢UU�� ja—1 pk-, z L -i ei&003
SUITE/UNIT
PROJECT VALUATION
$
ZONING
ASSESSOR'S TAI{/PARCEL #
;7 �� _ coo Go
TYPE OF PERMIT
UILDING ❑ PLUMBING ❑ MECHANICAL
❑ DEMOLITION ❑ ENGINEERING ❑ FIRE PREVENTION
NAME OF PROJECT
(Tenant Name/Homeowner Last Name)
�V I
1 I�
PROJECT DESCRIPTION
W
Detailed description of work to
be included on this permit only
PROPERTY OWNER
N E
��
PRIMARY PHONE
�6 3 v®_ ITC
MAILIN6�AjipRES3 � ^� �
_\/�/�/� SIJ
E-bIAIL
J
C
ST
ZI(��'lj (x,I
KJvV
NAME
PHONE
MAILING ADDRESS
E-MAIL
CONTRACTOR
CITY
STATE
ZIP
FAX
WA STATE CONTRACTOR'S LICENSE 8
EXPIRATION DATE
FEDERAL WAY BUSINESS LICENSE M
NAME
PHONE
APPLICANT
MAILING ADDRESS
E-MAIL
CITY
STATE
ZIP
FAX
PROJECT CONTACTHONE
(The individual to receive and
respond to all correspondence
concerning this application)
y7
(�f
MAILINGrryyADDRESS
E-MAIL
CITY
TAE
ZIP
FAX
y
V
ALTERNATE CONTACT NAME:
PHONE
E-MAIL
PROJECT FINANCING
NAME
OWNER -FINANCED
Required value of $5,000 or more
MAILING ADDRESS, CITY, STATE, ZIP
PHONE
(RCW 19.27095/
I certify under penalty of perjury that I am the property owner or authorized agent of the property owner. I certify that to the best
of my knowledge, the information submitted in support of this permit application is true and correct. I certify that I will comply with
all applicable City of Federal Way regulations pertaining to the work authorized by the issuance of a permit. I understand that the
issuance of this permit does not remove the owner's responsibility for compliance with local, state, or federal laws regulating
construction or environmental laws.
I further agree to hold harmless the City of Federal Way as to any claim (including costs, expenses, and attorneys' fees incurred in
the investigation and defense of such claim/, which may be made by any person, including the undersigned, and fled against the city,
but only where such claim arises out of the reliance of the city, including its officers and employees, upon the accuracy of the
information supplied to the city part of this a plication.
/�
SIGNATURE: DATE 1 !t/ j2—
PRINT NAME: / f/1)A-)
ZOU letin #100 - January 1, 2011 Page 1 of 3 k:UHandouts\Permit Application
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